HomeMy WebLinkAbout2010-00780 - addition CITY OF ORONO PERMIT NO.: 2o�aoo�so
2750 KELLEY PARKWAY
,f` ORONO, MN 55356- DATE IssuEn: 08/30/2010
' 952 249-4600 FAX: 952 249-4616
ADDRESS : 60 MYRTLEWOOD RD
PIN : 36-118-23-33-0020
LEGAL DESC : REG.LAND SURVEY NO.0446
: LOT 000 BLOCK 000
PERMIT TYPE : ADVANCED PLAN REVIEW
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADVANCED PLAN REVIEW
VALUATION : $ 120,000.00
NOTE: PLEASE FILL IN THE FOLLOWING:
VALUATION OF PERMIT:$ 120,000.00
TYPE OF PERMIT THIS PAYMENT IS FOR: ADDITION
PERMIT#THIS PRE-PAYMENT IS TIED TO:2010-00780
APPLICANT ADVANCED PLAN REVIEW 764.89
PLEKKENPOL BUILDERS TOTAL 764.89
401 E 78TH ST
BLOOMINGTON,MN 5542a PAID WITH CC# 3447
(952)888-2225
Minnesota State License#: 1797
OWNER
HARTMAN,TODD
60 MYRTLEWOOD RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This pertnit is for only the work described and does
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
/ / / /
Applicant Permitee Signature Date Issued By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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�. C�ty of Orono `����� � �'�
' • • ' ' tion �
� Bu�iding Permit Appl�ca
for New Structures or Additions ���-ao�8/
Mailing Address: Permit number: ��70� l�
O�Q J�'O PO Box 66 �jeYl�K�
�`r Crystal Bay,MN 55323-0066 Date received: d
Street Address:' Received by:
� �,� 2750 Kelley Parkway Plan review fee:�
�0�,4• Orono, MN 55356
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us `��' V
This application form must be compieted in fuil and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: ��'�>
Job Site Address: (�I� �t { iI"f l C:�� � '�z-% -
Will this be a Parade of Homes, Remodele howcase Home or other D�splay Home? Yes No
If yes,a specfal event pemiit is requirad with Police Depariment and City Councif approval 60 days prior to the everrt. Shuttle bus service will be
repuired unless applicard demonstrates s�cient on�8e parking is available. Non-permitted events wi0 not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: �C.�:KICC-NPCc, b���Pt-�t
State License# Expiration Date: � i/
Phone: q S�- g8 - z7�.Z 5 (office} (��� -��S -�3�'� (���1
Mailing Address: y o/ CA 7 '� C� : vor� r+v rJ Z�P: S � Z
Corrtact Person: � ,.�.- � Applicant is: n ra ' / Homeowner �c�ra.00.►
Email and/or Fax: R��u ����kc'�-'P�� . C��^'� S� 8$�'2-259
PROPERTY OWNER INFORMATION:
Name: TQ�17 FF n�c� �r"�� /�A 2�M A�S
Phone(day): C'�,i 2- 518 - Z2�'//
Address: �D /rlYrr-���.r��� 2c�� �ity: c�rZ��,.��Q Z1P: 5�39�
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name:
Phone(day):
Address: Ciry: ZIP:
Emaii andlor Fax:
PROJECT INFORMATION:
1.Type ot Project 2.Proposed Use 3.Structure Type 4'��� Supply�'�
❑New Construction �Single Farrrity with �Re�dence
,�"Addition atbeched garage ❑Garage/Accessory Bldg. ❑Public Sewer
❑Accessory Building ❑ Sin�e Family with ❑Deck
❑Relocation detached garage ❑Office/Commeraal ❑Private Sewer
❑Oiher:(speaTy) ❑Multiple Family/Condo ❑Warehouse
❑Public ❑Storage ❑Public Water
"Any earth movement may requlre ❑Commercial ❑Other(specify)
MCWD review b permlts. ❑Ind�trial ❑Private Well
Minnehaha Creek VYatershed Distric�(MCWD) ❑Other.(specify)
18202 Minnetonka Bhrd
Deephaven,MN 55381
Phone: 952-471-0590
Fax: 952a171-0682
www.minnehahacreek.
Estimated Construction Valuation(excluding land) S / Z U C9�?
Last Updated: 9/23/2009
-17-